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  • Stein, Janine  (52)
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  • 1
    Language: English
    In: Health and Quality of Life Outcomes, 01 July 2017, Vol.15(1), pp.1-8
    Description: Abstract Background Thus far, only a few longitudinal studies investigated the impact of social engagement on health-related quality of life (HRQoL) and depressive symptoms in old age. Therefore, we aimed to examine the impact of social engagement on HRQoL and depressive symptoms in late life....
    Keywords: Depressive Symptoms ; Eq-Vas ; Geriatric Depression Scale ; Health-Related Quality of Life ; Old Age ; Public Health
    E-ISSN: 1477-7525
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  • 2
    Language: English
    In: Social psychiatry and psychiatric epidemiology, February 2012, Vol.47(2), pp.263-70
    Description: In the last decades, many community-based studies have addressed predictors of nursing home placement (NHP) among the elderly. So far, predictors have not been analyzed separately for different age groups. For a German GP-sample of 3,208 subjects aged 75 years and older, socio-demographic, clinical, and psychometric parameters were requested every 1.5 years over three waves. Logistic regression models determined predictors of NHP for total sample and for two different age groups. A CART analysis identified factors discriminating best between institutionalized and non-institutionalized individuals. Of the overall sample, 4.7% of the sample (n = 150) was institutionalized during the study period. Baseline characteristics associated with a higher risk of NHP for the total sample were age, living without spouse, cognitive and functional impairment and depression. In the CART analysis, age was the major discriminator at the first level (at age 81). In subgroup regression analyses, for the younger elderly (age 75-81) being single as well as cognitive and functional impairment increased the risk of NHP; in the advanced elderly (age 82+) being widowed and subjective memory impairment were significant predictors for NHP, and cognitive and functional impairment became non-significant as predictors of NHP. Predictors of NHP may differ in old age groups. The fact that many predictors show inconsistent results as predictors of NHP in the international literature may be attributed to the lack of differentiation in age groups.
    Keywords: Aging -- Psychology ; Cognition Disorders -- Epidemiology ; Dementia -- Epidemiology ; Institutionalization -- Trends
    ISSN: 09337954
    E-ISSN: 1433-9285
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  • 3
    Language: English
    In: Journal of Affective Disorders, 15 July 2016, Vol.199, pp.139-147
    Description: The study aimed at determining excess costs of late-life depression from a societal perspective. Moreover, the impact of recognition of depression by GPs on costs was investigated. Cross-sectional data were obtained from a large multicenter observational cohort study (AgeMooDe). Participants (n=1197) aged 75 years or older and were recruited via their GPs in Leipzig, Bonn, Hamburg, and Mannheim in Germany from May 2012 until December 2013. In the base case analysis, depression was assessed using the Geriatric Depression Scale (GDS; cutoff GDS≥6). Data on health care utilization and costs were based on participants' self-reports for inpatient treatment, outpatient treatment, pharmaceuticals, and formal and informal nursing care. Unadjusted mean costs in a six-month period for depressed individuals (€5031) exceeded those of non-depressed (€2700) by the factor 1.86 and were higher in all health care sectors considered. Statistically significant positive excess costs persisted in all formal health care sectors after adjusting for comorbidity and socio-demographics. Recognition of depression by the GP did not moderate the relationship of depression and health care costs. Analyses were restricted to a cross-sectional design, not permitting any conclusions on causal interference of the variables considered. The findings stress the enormous burden of depression in old age for all sectors of the health care system. The fact that GPs' recognition of depression does not moderate the relationship between depression and costs adds further insights into the economics of this frequent psychiatric disorder.
    Keywords: Late-Life Depression ; Older Adults ; Health Care Use ; Costs ; Germany, Health Services Research
    ISSN: 0165-0327
    E-ISSN: 1573-2517
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  • 4
    Language: English
    In: Journal of Affective Disorders, 01 November 2016, Vol.204, pp.247-254
    Description: Depression is the most common psychiatric disease in older people, often accompanied by co-morbidities and functional limitations. In cross-sectional studies, depression is associated with an increased use of health care resources, including informal care and home care. Longitudinal data are needed to better understand the causal links between depression, functional impairments, and health care utilization. Data were obtained at baseline and follow-up of the multicenter, prospective cohort study “Late life depression in primary care: needs, health care utilization and costs” (AgeMooDe). A sample of 955 primary care patients aged 75 years and older was interviewed twice. The primary outcomes were the average respective amounts of time spent utilizing home care, professional nursing care, domestic help and informal care. These outcomes were analyzed with Generalized Linear Mixed Models (GLMM). GLMM analysis revealed that the amount of time utilizing home care over the study period was positively associated with depression, higher age, and functional and cognitive impairments, but negatively associated with living alone. In-depth analyses revealed that these associations were particularly obvious for the utilization of informal care. The generalizability of our findings may be limited due to use of a dimensional instrument to determine depressive symptoms. Over the study period, the average amount of time receiving home care and especially informal care increased in the group of patients with depression only. People with depressive symptoms experience a growing number of functional limitations over time, increasing their dependency on others. Functional limitations, depression and dependency appear to form a vicious cycle.
    Keywords: Depression ; Elderly Population ; Health Services Research ; Home Care ; Informal Care
    ISSN: 0165-0327
    E-ISSN: 1573-2517
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  • 5
    In: Journal of the American Geriatrics Society, November 2016, Vol.64(11), pp.2311-2316
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/jgs.14458/abstract Byline: Andre Hajek, Christian Brettschneider, Dagmar Luhmann, Marion Eisele, Silke Mamone, Birgitt Wiese, Siegfried Weyerer, Jochen Werle, Michael Pentzek, Angela Fuchs, Steffi G. Riedel-Heller, Tobias Luck, Horst Bickel, Dagmar Weeg, Alexander Koppara, Michael Wagner, Martin Scherer, Wolfgang Maier, Hans-Helmut Konig,, Heinz-Harald Abholz, Cadja Bachmann, Wolfgang Blank, Hendrik den Bussche, Sandra Eifflaender-Gorfer, Annette Ernst, Kathrin Heser, Frank Jessen, Hanna Kaduszkiewicz, Teresa Kaufeler, Mirjam Kohler, Carolin Lange, Diana Lubisch, Melanie Luppa, Manfred Mayer, Edelgard Mosch, Julia Olbrich, Tina Posselt, Jana Prokein, Susanne Rohr, Anna Schumacher, Janine Stein, Susanne Steinmann, Franziska Tebarth, Klaus Weckbecker, Steffen Wolfsgruber, Thomas Zimmermann Keywords: visual impairment; physical function; cognitive function; older people; longitudinal study Objectives To examine how visual impairment affects physical and cognitive function in old age. Design A longitudinal population-based prospective cohort study. Setting General practitioner offices at six study centers in Germany. They were observed every 1.5 years over four waves. Participants Individuals aged 77-101 at follow-up Wave 2 (N = 2,394). Measurements Physical and cognitive function were assessed using an adapted scale that had been previously developed, and visual impairment was rated on a Likert scale (none, mild, severe or profound). Results Adjusting for sociodemographic factors and comorbidity, linear fixed-effects regression showed that the onset of severe visual impairment was associated with a decline in physical function score in the total sample ([beta] = -0.15, P = .01) and in women ([beta] = -.15, P = .03). Moreover, the onset of severe visual impairment was associated with decline in cognitive function score in the total sample ([beta] = -0.38, P 〈 .001) and in women ([beta] = -0.38, P 〈 .001) and men ([beta] = -0.37, P = .001). Conclusion Visual impairment affects physical and cognitive function in old age. Interventional strategies to postpone visual impairment may contribute to maintaining physical and cognitive function. Article Note: These authors contributed equally to this work. See Appendix 1. CAPTION(S): Table S1. Mean level of changes in visual impairment, physical and cognitive function (all treated as continuous variables) from FU Wave 2 to FU Wave 5. Table S2. Pairwise correlations in differences (from FU Wave 2 to FU Wave 5). Table S3. Predictors of physical function. Results of fixed effects regressions for individuals with complete data (FU Waves 2-5). Table S4. Predictors of cognitive function. Results of fixed effects regressions for individuals with complete data (FU Waves 2-5).
    Keywords: Visual Impairment ; Physical Function ; Cognitive Function ; Older People ; Longitudinal Study
    ISSN: 0002-8614
    E-ISSN: 1532-5415
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  • 6
    In: Journal of the American Geriatrics Society, July 2012, Vol.60(7), pp.1286-1291
    Description: Keywords: cardiovascular disease; diabetes mellitus; cognition; cognitive change Objectives To examine the effect of cardiovascular and metabolic diseases on initial cognitive test performance and rate of change in three cognitive measures. Design Prospective cohort study. Setting General practices in six towns throughout Germany. Participants Three thousand three hundred twenty-seven participants aged 75 and older (average 79.7 [+ or -] 3.6). Measurements Data were collected during home visits every 18 months and included sociodemographic variables, depression, disease status, drug intake, and cognition. Results Although the presence of transient ischemic attack (TIA) or stroke and diabetes mellitus was related to poor initial cognitive test performance, the presence of those and other far-reaching chronic diseases or a higher disease burden were not related to the rate of change in cognition over time. Conclusion Diabetes mellitus, stroke and TIA affect cognitive test performance beyond well-known sociodemographic variables and depressive symptoms, although none of these diseases contributed to cognitive decline over time. In practical terms, prevention and diagnosis of cardiovascular and metabolic diseases may be essential to cognitively healthy aging. Author Affiliation: Article Note:
    Keywords: Cardiovascular Disease ; Diabetes Mellitus ; Cognition ; Cognitive Change
    ISSN: 0002-8614
    E-ISSN: 1532-5415
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  • 7
    In: International Journal of Geriatric Psychiatry, October 2018, Vol.33(10), pp.1383-1388
    Description: Byline: Andre Hajek,Christian Brettschneider, Hendrik Bussche, Dagmar Luhmann, Anke Oey, Birgitt Wiese, Siegfried Weyerer, Jochen Werle, Angela Fuchs, Michael Pentzek, Janine Stein,Tobias Luck, Horst Bickel, Edelgard Mosch, Kathrin Heser, Michael Wagner, Martin Scherer, Wolfgang Maier, Steffi G. Riedel-Heller, Hans-Helmut Konig, Keywords: depression; falls; longitudinal study; oldest old Objective The purpose of this study was to examine the impact of falls on depressive symptoms among the oldest old in Germany longitudinally. Methods Data were used from 2 waves of the multicenter prospective cohort "Study on needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe). This study covers primary care patients a[yen]85 years (at baseline: n = 547, average age of 88.9 [+ or -] 3.0 years; ranging from 85 to 100 years). General practitioner-diagnosed falls were used as explanatory variable. The Geriatric Depression Scale was used as outcome measure. Results Linear fixed effects regressions showed that the occurrence of falls is associated with an increase in depressive symptoms ([beta] = .60, P = .02), whereas changes in marital status, ageing, social support, functional decline (instrumental activity of daily living), cognitive impairment, and an increase in chronic diseases did not affect depressive symptoms. In sensitivity analysis, an increase in depressive symptoms was associated with functional impairment (basic activities of daily living; Barthel index; [beta] = -.04, P = .005). Conclusions Based on a large, population-based longitudinal study, this study underlined the impact of falls on depressive symptoms and consequently extended previous knowledge about an association between falls and depressive symptoms in the oldest old. Developing strategies to prevent falls might also help to prevent depressive symptoms. Article Note: The authors Steffi G. Riedel-Heller and Hans-Helmut Konig equally contributed in this work.
    Keywords: Depression ; Falls ; Longitudinal Study ; Oldest Old
    ISSN: 0885-6230
    E-ISSN: 1099-1166
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  • 8
    In: Age and Ageing, 2017, Vol. 46(5), pp.813-820
    Description: Objective: to investigate how social support affects functional impairment (FI) in late life in a longitudinal approach.Methods: in a multicenter prospective cohort study, subjects in old age (≥75 years at baseline) were interviewed every 1.5 years. Social support was quantified in the follow-up (FU) Waves 2 and 4 (FU Wave 2: n = 2,349; FU Wave 4: n = 1,484). FI was assessed by using the Lawton and Brody Instrumental Activities of Daily Living scale.Results: fixed effects regressions showed that a decrease in social support is associated with FI in the total sample and in both sexes. The effect on FI was most pronounced with the dimension social integration, whereas changes in practical support only affected FI in the total sample and changes in emotional support only affected FI in men.Conclusions: our findings emphasise the importance of social support for functional status in late life. Thus, strengthening social support in old age might be effective in maintaining functional abilities.
    Keywords: Social Support ; Functional Impairment ; Iadl ; Longitudinal Study ; Older People
    ISSN: 0002-0729
    E-ISSN: 1468-2834
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  • 9
    Language: English
    In: Psychological Assessment, 2015, Vol.27(3), pp.895-904
    Description: The aim of the study was to investigate the psychometric properties of a Short Form of the Mini-Mental State Examination (SMMSE) for the screening of dementia in older primary care patients. Data were obtained from a large longitudinal cohort study of initially nondemented individuals recruited via primary care chart registries and followed at 18-month intervals. Item and scale parameters for MMSE and SMMSE scores were analyzed and cross-validated for 2 follow-up assessments ( n 1 = 2,657 and n 2 = 2,274). Binary logistic regression and receiver-operating-characteristic (ROC) curve analyses were conducted in order to assess diagnostic accuracy parameters for MMSE and SMMSE scores. Cross-sectional differentiation between dementia-free and dementia patients yielded moderate to good results for MMSE and SMMSE scores. With regard to most diagnostic accuracy parameters, SMMSE scores did not outperform the MMSE scores. The current study provides first evidence regarding the psychometric properties of the SMMSE score in a sample of older primary care patients. However, our findings do not confirm previous findings that the SMMSE is a more accurate screening instrument for dementia than the original MMSE. Further studies are needed in order to assess and to develop short, reliable and valid instruments for routine cognitive screening in clinical practice and primary care settings.
    Keywords: Mini-Mental State Examination ; Short Form Of The Mini-Mental State Examination ; Screening ; Psychometric Properties ; Dementia
    ISSN: 1040-3590
    E-ISSN: 1939-134X
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  • 10
    Language: English
    In: PLoS ONE, 01 January 2015, Vol.10(12), p.e0144203
    Description: OBJECTIVE:To investigate time-dependent predictors of institutionalization in old age using a longitudinal approach. METHODS:In a representative survey of the German general population aged 75 years and older predictors of institutionalization were observed every 1.5 years over six waves. Conditional...
    Keywords: Sciences (General)
    E-ISSN: 1932-6203
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